Diagnosis of Tracheo-Esophageal Fsitula Three Dimensional Virtual Bronchoscope: Case Report

Acquired T-E (tracheo-esophageal) fistula is a complication of esophageal cercinoma. Esophagography with barium sulfate, or water soluble contrat medium and fiberoptic bronchoscopy are the traditinoal methods for the diagnosis of T-E fistula. In out department, the virtual bronchoscpy reconstruction technique has become a useful non-invasive method to provide anatomical information on the airway. We present two male patients (patient 1 & patient 2) of suspected T-E fistula formation with underlying primary and secondary esophageal carcimoma. They were diagnosed with thin slice spiral computer tomography (CT) with 3D virtual bronchoscopic reconstruction. Orifice of T-E fistula was noted in patient 1 but was not in patient 2. The follow-up fiber brochoscopy study and clinical outcome support our results. We find that virtual images reconstructed by computer offer satisfactory resolution.(Tzu Chi Med J 2003; 15:63-67)